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1154488831
TERRY WAYNE FONVILLE
NEW YORK, NY
NPI
1154488831
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: NY 107804)
Enumeration Date
2007-01-02
Last Update Date
2012-07-31
Business Address
MR. TERRY WAYNE FONVILLE MD
99 UNIVERSITY PL SUITE 201
NEW YORK, NY 10003-4528
Phone number: 212-222-7516
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Mailing Address
MR. TERRY WAYNE FONVILLE MD
99 UNIVERSITY PL SUITE 201
NEW YORK, NY 10003-4575
Phone number: 212-222-7516
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